Obel, J.;Souares, Y.;Hoy, D.;Baravilala, W.;Garland, S.M.;Kjaer, S.K.;Roth, A.
Asian Pacific Journal of Cancer Prevention
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제15권21호
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pp.9433-9437
/
2014
This study provides the first systematic literature review of cervical cancer incidence and mortality as well as human papillomavirus (HPV) genotype prevalence among women with cervical cancer in the Pacific Island countries and territories. The cervical cancer burden in the Pacific Region is substantial, with age standardized incidence rates ranging from 8.2 to 50.7 and age standardized mortality rate from 2.7 to 23.9 per 100,000 women per year. The HPV genotype distribution suggests that 70-80% of these cancers could be preventable by the currently available bi- or quadrivalent HPV vaccines. There are only few comprehensive studies examining the epidemiology of cervical cancer in this region and no published data have hitherto described the current cervical cancer prevention initiatives in this region.
Background: Despite many epidemiological studies on the effects of dietary antioxidant micronutrients on risk of cervical cancer, the findings remain uncertain and little evidence is available for serum nutrient markers. The present study aimed to examine the relationship between serum carotenoid, retinol and tocopherol concentrations and risk of cervical cancer among Chinese women. Materials and Methods: We conducted a hospital-based case-control study in which 358 adults (158 incident cases and 200 controls) were recruited from Xinjiang, China. Serum levels of carotenoids (${\alpha}$-carotene, ${\beta}$-carotene, ${\beta}$-cryptoxanthin, lycopene and lutein/zeaxanthin), retinol, and tocopherols (${\alpha}$-tocopherol and ${\gamma}$-tocopherol) were assessed by reverse-phase high-performance liquid chromatography. Results: We found inverse associations between serum carotenoid (${\alpha}$-carotene, ${\beta}$-carotene, and lutein/zeaxanthin) and tocopherol (${\alpha}$-tocopherol) concentrations and the risk of cervical cancer after adjusting for potential confounders, but a null association for retinol. The ORs for 1-SD increase were 0.71 (95 % CI: 0.56-0.92; p=0.003) for total carotenoids and 0.75 (95 % CI: 0.60-0.94; p=0.008) for total tocopherols. Conclusions: These results show that higher serum concentrations of some carotenoids and tocopherols are associated with a lower risk of cervical cancer among Chinese women.
Purpose: This study was done to identify frequency, intensity of urinary dysfunction and daily life distress in women after a radical hysterectomy for cervical cancer. Methods: One hundred and fifty seven women who had undergone a radical hysterectomy and one hundred and sixty five women as healthy controls completed questionnaires on intensity of urinary dysfunction and daily life distress caused by urinary dysfunction. Results: Women with cervical cancer showed higher frequency of urinary dysfunction than healthy controls. Major urinary dysfunction for women with cervical cancer in order of frequency were night-time incontinence (odds ratio=10.39, p<.001), difficulty in starting urination, weak urine stream and sense of incomplete emptying of bladder. The highest score on intensity was difficulty in starting urination, followed by urgency, weak urine stream, daytime frequency and sense of incomplete emptying. Night-time incontinence was the urinary symptom causing the most daily life distress for cervical cancer women followed by difficulty in starting urination, urgency, sense of incomplete emptying, and night-time frequency. Conclusion: Results suggest that nurses should address the potential postoperative urinary complications and develop long term interventions to decrease urinary dysfunction and daily life distress for women who have had a radical hysterectomy for cervical cancer.
Background: To determine rates of residual disease along with influencing factors in women with stage IA to IB1 cervical carcinoma after conization. Materials and Methods: A retrospective study was conducted of medical records of 198 stage IA to IB1 cervical carcinoma patients who had undergoing cervical conization followed by primary surgical treatment during 2006-2013. Independent factors correlating with residual carcinoma in subsequent surgical specimens were analyzed by stepwise regression analysis. Results: Mean age was 48.9 years. Cone specimens demonstrated free margins in 36 women (18.8%). In case of having disease at margin, high-grade cervical intraepithelial neoplasia (CIN) and carcinoma were evidenced in 58 and 97 women, respectively. Pathology of subsequent specimens revealed residual carcinoma in 78 women (39.4%), high-grade CIN or adenocarcinoma in situ (AIS) in 45 (22.7%), and no residual pathology in 75 (37.9%). Age more than 35 years, postmenopausal status, having symptoms, diseases or invasive lesions at conization margins or disease on endocervical aspect, and higher stage were significantly correlated with residual cancer in surgical treatment specimens. On regression analysis, postmenopause and stage were independent factors associated with residual carcinoma.Conclusions: Patient and tumor characteristics are predictive factors for residual cancer in the studied group of women.
Mukem, Suwanna;Meng, Qingyue;Sriplung, Hutcha;Tangcharoensathien, Viroj
Asian Pacific Journal of Cancer Prevention
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제16권18호
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pp.8541-8551
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2016
Background: The coverage of breast and cervical cancer screening has only slightly increased in the past decade in Thailand, and these cancers remain leading causes of death among women. This study identified socioeconomic and contextual factors contributing to the variation in screening uptake and coverage. Materials and Methods: Secondary data from two nationally representative household surveys, the Health and Welfare Survey (HWS) 2007 and the Reproductive Health Survey (RHS) 2009 conducted by the National Statistical Office were used. The study samples comprised 26,951 women aged 30-59 in the 2009 RHS, and 14,619 women aged 35 years and older in the 2007 HWS were analyzed. Households of women were grouped into wealth quintiles, by asset index derived from Principal components analysis. Descriptive and logistic regression analyses were performed. Results: Screening rates for cervical and breast cancers increased between 2007 and 2009. Education and health insurance coverage including wealth were factors contributing to screening uptake. Lower or non-educated and poor women had lower uptake of screenings, as were young, unmarried, and non-Buddhist women. Coverage of the Civil Servant Medical Benefit Scheme increased the propensity of having both screenings, while the universal coverage scheme increased the probability of cervical screening among the poor. Lack of awareness and knowledge contributed to non-use of both screenings. Women were put off from screening, especially Muslim women on cervical screening, because of embarrassment, fear of pain and other reasons. Conclusions: Although cervical screening is covered by the benefit package of three main public health insurance schemes, free of charge to all eligible women, the low coverage of cervical screening should be addressed by increasing awareness and strengthening the supply side. As mammography was not cost effective and not covered by any scheme, awareness and practice of breast self examination and effective clinical breast examination are recommended. Removal of cultural barriers is essential.
Background: This descriptive study was performed in order to assess health perspectives of women, who applied to Yildirim Beyazit University Ataturk Education and Research Hospital, Outpatient Clinic of Obstetrics and Gynecology for cervical cancer scans and were in the reproductive years. Factors influencing their perspectives were also assessed. Materials and Methods: In this study, a simple random sampling formula was adopted to calculate the volume (300) of the targeted sample. Results of the research were obtained through individual diagnosis form and cervical cancer and the Pap smear test health belief model scale (HBMS). Results: It was found that 75.0% of the women heard of the Pap smear test before, and 48.7% had undertaken one. Some 51.4% of the women who had Pap smear test expressed that they had the test at irregular periods. Most of the women stated that they heard about the smear test from the health staff (51.7%). Lack of any health complaints (28.3%) and not having adequate information about the test (21.0%) were among the reasons for not undergoing a Pap smear test. It was found that lower dimension average scores of the women obtained from the cervical cancer and Pap smear test HBMS varied from $7.7{\pm}2.3$ to $33.5{\pm}9.3$. When the lower dimension average scores of women from the HBMS were examined, the perception of usefulness was high but the susceptibility and health motivations were low. Conclusions: In this study, it was determined that the awareness of women about cervical cancer and the Pap smear test was insufficient, and susceptibility and motivation perception towards having a Pap smear test were low.
The purpose of this study was to explore the experience of Pap smear screening of menopausal women in W city using a phenomenological methodology. The participants were 5 focus groups consisting of 37 menopausal women. They were selected using snowball sampling method. The data were collected through focus group interviews. Data were recorded and analyzed by Colazzi's method. Significant statements were extracted from the data resulting in 20 themes. These themes formed 12 clusters and 5 categories. The essential themes of the experience of cervical cancer screening emerged as : "unpleasant feelings during procedure", "ambivalent feelings about results", "be guided to seek health", "shrink from interaction with health professionals", "at ease about cervical cancer". The results indicated that cervical cancer prevention strategies for menopausal women need to be based on deep under standing of the personal experiences of Pap smear screening. In conclusion, it is suggested that more specified strategies are needed for menopausal women to encourage them to have regular screening.
Background: In Aotearoa/New Zealand cervical screening programmes have reduced cervical cancer; however, half of cervical cancer cases among Pacific women are found among clients who had not attended cervical screening. Hence, we set out to determine health provider perspectives on barriers that prevent their services reaching Pacific women within Aotearoa/New Zealand. Materials and Methods: Twenty semi-structured interviews were conducted with health care providers, Pap smear takers and community workers in the Wellington region. Participants were asked their views on factors that enabled and/or constrained the participation of Pacific women in their cervical screening services. Results: Six interrelated themes influencing participation in cervical screening among Pacific women in the Wellington region were apparent: the funding and practice of service delivery; family always coming first; the cost of screening services; type of employment; the appropriateness of information; and attitudes to self and screening. Conclusions: Determining specific ethnic group actual health needs and meeting them contributes to overall improvement in New Zealand's health status. The results identified the need for improvements to the delivery of screening services including adapting cervical screening services to the requirements of Pacific women through more outreach services at alternate clinic hours; culturally appropriate practitioners; the ability to take up opportunities for health checks and foster long-term relationships; as well as appropriate monitoring and evaluation of approaches. Funding and reporting relationships also need to be compatible with the goal of improving outcomes for Pacific women. Further research into client voices for their particular needs to compliment the service provider perspective as well as minority groups is called for.
Aminisani, N;Fattahpour, R;Abedi, L;Shamshirgaran, SM
Asian Pacific Journal of Cancer Prevention
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제17권8호
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pp.3763-3767
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2016
Background: Cervical cancer is the second most common cancer among females across the world. It is a preventable cancer and early detection is very feasible. This study aimed to identify which women characteristics are potentially associated with and may have an important in uence on the uptake of cervical cancer screening in Kurdish women living in the west of Iran.. Materials and Methods: A cross sectional study was conducted in late 2014. A random sample of women aged 40 years and above without history of cervical cancer and identi ed as Kurdish background were selected and interviewed by two trained interviewers. Information about sociodemographic and reproductive factors, history of diseases, and cervical screening was collected using a questionnaire and women who had undergone a hysterectomy were excluded. Univariate analyses were used to describe the general characteristics of the study population. Multivariable logistic regression models with self-reported screening history were used to estimate odds ratios (ORs) with 95% con dence intervals (CI). Signi cance was considered at the 5% level. Results: A total of 561 women were included in this study (mean age $43.6{\pm}5.17$ years) participation in cervical screening at least once was about 32%. Cervical screening uptake percentage was signi cantly lower among people over 60 years of age (adjusted OR= 0.26, 95% CI: 0.11-0.64), and those who were illiterate (OR= 0.41 95% CI: 0.23-0.73) and post-menopausal (OR= 0.56, 95% CI: 0.35-0.91). Women with ${\leq}1$ child were less likely to report a Pap test (adjusted OR=0.43 95%CI: 0.13-1.37) Cervical screening uptake was higher among women with health insurance (OR= 2.31, 95% CI: 1.50-3.56). Conclusions: Cervical screening participation in this study was low compared to other studies in developed countries. The screening uptake was different based on age, education, parity, insurance coverage and menopausal status. It is recommended to target these groups of women in cervical screening program.
Background: Level of midwife knowledge is particularly important because of their role in the cervical cancer prevention programme. The aim of this study was to examine differences in the level of knowledge among health care students, midwives and women in the general population of Serbia. Materials and Methods: A cross-sectional approach was used with health care students of the medical shool, midwives in their practice, and women visiting a chosen general practitioner as respondents. Results: In comparison with the students and midwives, women had lower level of knowledge of causative agents of the cervical cancer, genital warts, HPV types, screening for cervical cancer as well as about the target population for vaccine and its role. Differences in the numbers of right answers of respondents were statistically significant (p<0.001). Four or more correct answers were obtained from 22.7% women, 35.3% from midwives and 83.8% from students. Conclusions: Midwives should improve their own level of knowledge related to preventive practice for cervical cancer, as well as their personal compliance with recommended practices, in order to be qualified and credible promoters of cervical cancer control among women in Serbia.
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